concierge medicine

Introduction

Agreement between a patient & physician for which the patient pays an annual fee for increased access to that physician.

Notes

• physicians choosing concierge medicine have elected to opt-out of Medicare
• this opt-out decision applies to all patients in the physician practice, he/she may not choose Medicare for some, concierge for others
• the physician must sign an affidavit agreeing to forego any payment from Medicare for a 2 year period
  • physician must file an affidavit 30 days prior to the 1st day of the next calendar quarter
  • for 90 days after the effective date of the 1st opt-out affadavit, a physician may change their mind & return to providing Medicare coverage
• contract between physician & patient must be in writing & signed prior to providing any services
• patient must give up Medicare payment for concierge medicine services
• patient must agree not to bill Medicare or ask physican to bill Medicare for concierge medicine services
• patient is liable for all physician's charges without any Medicare billing limits
• patient must acknowledge that Medigap or other supplemental insurances will not pay for concierge medicine services
• contract cannot be signed when a patient is facing an emergency or urgent health issue
• patient has right to recieve services from physcian(s) participating in Medicare
• Medicare part D coverage may provided for pharmaceuticals precribed by concierge physicians